Are you in a new health plan? Here’s how to make sure you get your meds.

| January 9, 2014

pillsDownload this fact sheet as a PDF.

Worried you’ll have trouble getting the medications that you need in a new health plan? If you signed up for Medicaid, private insurance, or have a new plan through your job, all kinds of glitches are possible. It’s critical for people with HIV to not miss a dose of their medications so they don’t develop resistance. If you find yourself in a situation where your medications may not be covered for a certain period of time, we have some ideas to help you.

 Plan ahead – get a refill before switching
Give yourself some extra time to make sure everything is working by refilling your medications before you make the switch to a new health plan. You’ll be covered if there’s a glitch. You can ask your pharmacist for a “partial refill” if it’s too soon for a full 30-day refill.

Find Out What Your State ADAP Can Do
Many state AIDS Drug Assistance Programs (ADAP) can step in and provide coverage in a pinch, especially if you are leaving ADAP for Medicaid or private insurance. To find out what assistance you may be eligible for, contact your individual state ADAP.

Ask your pharmacy for help
Many local pharmacies can provide “bridge supplies” to make sure you get meds. Two pharmacies, Walgreens and CVS Caremark, announced special transition plans, and others may have similar policies in place.  They may provide 15-30 day supplies, and bill your insurance plan once your coverage kicks in.  They may also bill you later for a co-pay.

Pharmaceutical Co-pay Assistance Programs
If you can’t get help from your pharmacy, or can’t afford the costs of medications, a pharmaceutical manufacturer assistance program may be able to help.  HarborPath.org and the Partnership for Prescription Assistance (www.pparx.org) are two places to start.

Contact your doctor or case manager
Remember, you’re not alone.  Your health care provider and case manager are there to help if you can’t get your medications.  Give them a call and ask for help.

We realize how important it is to stay on schedule in terms of medication. We hope these ideas will help you stay on track and keep you covered.

What strategies have you used to get meds when you run into problems? Share them with us!  Send an email to hhr@aidschicago.org.

Download the PDF version here.

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